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opioid free

S Sukhbir, S Yashpal, A Sandeep
Nefopam hydrochloride (NFH) is a non-opioid centrally acting analgesic drug used to treat chronic condition such as neuropathic pain. In current research, sustained release nefopam hydrochloride loaded nanospheres (NFH-NS) were auspiciously synthesized using binary mixture of eudragit RL 100 and RS 100 with sorbitan monooleate as surfactant by quasi solvent diffusion technique and optimized by 3(5) Box-Behnken designs to evaluate the effects of process and formulation variables. Fourier transform infrared spectroscopy (FTIR), differential scanning calorimetric (DSC) and X-ray diffraction (XRD) affirmed absence of drug-polymer incompatibility and confirmed formation of nanospheres...
September 2016: Saudi Pharmaceutical Journal: SPJ: the Official Publication of the Saudi Pharmaceutical Society
Raquel Ajo, Ana Segura, Laura Mira, María-Del-Mar Inda, Rocío Alfayate, Angel Sánchez-Barbie, César Margarit, Ana M Peiró
BACKGROUND: Opioids are an effective treatment for chronic non-malignant pain (CNP). Long-term use risks and side effects such as opioid-induced androgen deficiency (OPIAD) exist. This could be measured by saliva testosterone (Sal-T). OBJECTIVES: To evaluate OPIAD in long-term opioid use in CNP patients. METHODS: A cross-sectional study included CNP male outpatients under opioid treatment. Total-Testosterone (Total-T), Free-Testosterone (Free-T), Bio-Testosterone (Bio-T) and Sal-T were measured...
October 18, 2016: Aging Male: the Official Journal of the International Society for the Study of the Aging Male
Major Vishal Arora, Mohammad Zafeer Khan, Major Sanjay Choubey, Mohammad Asim Rasheed, Arindam Sarkar
CONTEXT: Various adjuvants are being used with local anesthetics for prolongation of intraoperative and postoperative analgesia. The α2-adrenergic agonist clonidine and potent opioid buprenorphine have the ability to potentiate the effects of local anesthetics. AIMS: The purpose of this prospective, double-blind study was to compare onset, duration of sensory and motor block, effect on hemodynamics, level of sedation, duration of postoperative analgesia, and any adverse effects of clonidine and buprenorphine...
September 2016: Anesthesia, Essays and Researches
Amit Agrawal, Veena Asthana, J P Sharma, Vineeta Gupta
BACKGROUND: Subarachnoid block is the preferred technique for providing anesthesia for patients undergoing cesarean section. Various pharmacological agents in added to local anesthetics (LA) modify their original effects in terms of block characteristics and quality of analgesia. However, there is ongoing debate about this practice of using adjuncts with LA. We tested whether addition of lipophilic versus lipophobic opioids to LA gives any clinical benefits to maternal and fetal outcome when used in these patients requiring spinal anesthesia...
September 2016: Anesthesia, Essays and Researches
Joseph C Dort, D Gregory Farwell, Merran Findlay, Gerhard F Huber, Paul Kerr, Melissa A Shea-Budgell, Christian Simon, Jeffrey Uppington, David Zygun, Olle Ljungqvist, Jeffrey Harris
Importance: Head and neck cancers often require complex, labor-intensive surgeries, especially when free flap reconstruction is required. Enhanced recovery is important in this patient population but evidence-based protocols on perioperative care for this population are lacking. Objective: To provide a consensus-based protocol for optimal perioperative care of patients undergoing head and neck cancer surgery with free flap reconstruction. Evidence Review: Following endorsement by the Enhanced Recovery After Surgery (ERAS) Society to develop this protocol, a systematic review was conducted for each topic...
October 13, 2016: JAMA Otolaryngology—Head & Neck Surgery
Iain A Kaan, Geoffrey McCaughan, Tracey Jones
OBJECTIVE: To determine the likely current capacity of accredited treatment centres in treating hepatitis C (HCV) patients with Interferon free Direct Acting (DAA) Antiviral agents in Australia. METHOD: Data was collected from 22 centres before the introduction of DAA therapy - 11 sites from the Study 1 survey and an additional 11 sites from the Study 2 survey. The sites were selected based on consensus by viral hepatitis experts, in consultation with the NSW Agency for Clinical Innovation...
September 26, 2016: Internal Medicine Journal
Meagan Cea, M C Reid, Charles Inturrisi, Lisa R Witkin, Holly G Prigerson, Yuhua Bao
CONTEXT: Knowledge is limited regarding pain assessment and management practices, as well as pain-related outcomes in hospice care. OBJECTIVES: To generate national estimates of pain assessment and management practices and outcomes of pain control among patients 65 years or older receiving hospice care in the U.S. and to identify hospice discharge and agency characteristics predicting study outcomes. METHODS: The 2007 National Home Health and Hospice Care Survey was analyzed...
September 29, 2016: Journal of Pain and Symptom Management
Michael Kidorf, Carl Latkin, Robert K Brooner
The present study evaluated the presence of drug-free family and friends in the personal social networks of individuals seeking treatment for opioid use disorder, and the willingness of patients to bring these individuals to the treatment program to support recovery efforts. Patients at a community medication-assisted treatment program (n=355) completed a clinical survey to identify drug-free social network members. Results showed that almost all patients (98%) reported having at least one drug-free family or friend in their personal network (M=3...
November 2016: Journal of Substance Abuse Treatment
Ying Wang, Jianxun Lei, Mihir Gupta, Fei Peng, Sarah Lam, Ritu Jha, Ellis Raduenz, Al J Beitz, Kalpna Gupta
Integrative approaches such as electroacupuncture, devoid of drug effects are gaining prominence for treating pain. Understanding the mechanisms of electroacupuncture induced analgesia would benefit chronic pain conditions such as sickle cell disease (SCD), for which patients may require opioid analgesics throughout life. Mouse models are instructive in developing a mechanistic understanding of pain, but the anesthesia/restraint required to administer electroacupuncture may alter the underlying mechanisms. To overcome these limitations, we developed a method to perform electroacupuncture in conscious, freely moving, unrestrained mice...
September 30, 2016: Scientific Reports
Juan P Cata, Mariana Chavez-MacGregor, Vicente Valero, Walter Black, Daliah M Black, Farzin Goravanchi, Ifey C Ifeanyi, Mike Hernandez, Andrea Rodriguez-Restrepo, Vijaya Gottumukkala
BACKGROUND AND OBJECTIVES: The impact of regional anesthesia on breast cancer recurrence is controversial. We tested the hypothesis that the use of paravertebral block (PVB) analgesia during breast cancer surgery prolongs the recurrence-free survival (RFS) and overall survival (OS) of women with breast cancer. METHODS: Seven hundred ninety-two women with nonmetastatic breast cancer were included in this retrospective study. Patients were divided based on the administration of PVB analgesia for mastectomy surgeries...
September 28, 2016: Regional Anesthesia and Pain Medicine
Rebecca E Guilkey, Claire B Draucker, Jingwei Wu, Zhangsheng Yu, Kurt Kroenke
INTRODUCTION: Persistent musculoskeletal pain is a prevalent, disabling, and often undertreated condition. This paper examines the acceptability of a telecare intervention for this condition. METHODS: The Stepped Care to Optimize Pain Care Effectiveness (SCOPE) intervention couples automatic symptom monitoring (ASM) with optimized analgesic care management by a nurse-physician team. Data from participants in the telecare intervention arm (n = 124) of a randomized control trial of SCOPE were analysed to determine the acceptability of the telecare intervention as indicated by patient use and satisfaction...
September 27, 2016: Journal of Telemedicine and Telecare
Anna E Mechling, Tanzil Arefin, Hsu-Lei Lee, Thomas Bienert, Marco Reisert, Sami Ben Hamida, Emmanuel Darcq, Aliza Ehrlich, Claire Gaveriaux-Ruff, Maxime J Parent, Pedro Rosa-Neto, Jürgen Hennig, Dominik von Elverfeldt, Brigitte Lina Kieffer, Laura-Adela Harsan
Connectome genetics seeks to uncover how genetic factors shape brain functional connectivity; however, the causal impact of a single gene's activity on whole-brain networks remains unknown. We tested whether the sole targeted deletion of the mu opioid receptor gene (Oprm1) alters the brain connectome in living mice. Hypothesis-free analysis of combined resting-state fMRI diffusion tractography showed pronounced modifications of functional connectivity with only minor changes in structural pathways. Fine-grained resting-state fMRI mapping, graph theory, and intergroup comparison revealed Oprm1-specific hubs and captured a unique Oprm1 gene-to-network signature...
October 11, 2016: Proceedings of the National Academy of Sciences of the United States of America
Y Ghebre, G Raghu
Proton pump inhibitors (PPIs) are structurally composed of benzimidazole core; a pharmacologically common scaffold that makes up nearly one quarter of the hundred most selling drugs including anticancer, opioid, antihistaminic and antihelmintic drugs. In medicinal chemistry, benzimidazoles are coined as privileged scaffolds due to their ability to recognize and bind diverse biological targets. In this regard, PPIs have been linked to other extra-intestinal functions including direct modulation of airway epithelial, vascular endothelial and immune cells...
September 2016: QJM: Monthly Journal of the Association of Physicians
Koddus Ali, Jon Raphael, Salim Khan, Mourad Labib, Rui Duarte
Opioids commonly used for pain relief may lead to hypogonadism, which is characterised by suppression of production of the gonadotropin-releasing hormone (GnRH) resulting in inadequate production of sex hormones. The aim of this narrative review was to highlight the effects of opioids on the endocrine system and the development of hypogonadism. MEDLINE, EMBASE and Cochrane Library were searched for relevant articles investigating hypogonadism in patients undertaking opioid therapy by using a combination of both indexing and free-text terms...
September 19, 2016: Postgraduate Medical Journal
Tomasz Gaszynski
INTRODUCTION: We report on the anesthetic management using opioid-free method of a patient with Steinert syndrome (myotonic dystrophy, MD), autosomal dominant dystrophy which is characterized by consistent contracture of muscle following stimulation. A myotonic crisis can be induced by numerous factors including hypothermia, shivering, and mechanical or electrical stimulation. In patients with MD, hypersensitivity to anesthetic drugs, especially muscle relaxants and opioids, may complicate postoperative management...
September 2016: Medicine (Baltimore)
Masanori Mori, Yongli Ji, Santosh Kumar, Takamaru Ashikaga, Steven Ades
BACKGROUND: Methylnaltrexone is a peripherally acting mu-opioid receptor antagonist that has been shown to relieve severe opioid-induced constipation (OIC) in patients with advanced disease receiving palliative care. Its efficacy remains unknown in cancer patients who are not terminally ill. The primary aim of this study was to evaluate the efficacy of methylnaltrexone over 48 h in cancer patients who were not terminally ill. METHODS: In this single-dose phase II trial, cancer patients with a prognosis of ≥3 months and OIC with <3 laxations during the preceding week were eligible...
September 15, 2016: International Journal of Clinical Oncology
Haifeng Jiang, Maureen Hillhouse, Jiang Du, Shujun Pan, Ang Alfonso, Jun Wang, Zhirong Zhou, Weijun Yuan, Walter Ling, Min Zhao
The purpose of this study was to investigate the blood levels of methadone in participants receiving methadone for the treatment of opioid dependence. After stabilization on methadone for four weeks, blood samples from 95 participants were collected between treatment weeks 4 and 12, before and after receiving doses of methadone, and its blood levels were measured. A multiple linear regression model was used to examine the association between methadone blood levels and the outcomes of methadone maintenance treatment (MMT)...
September 10, 2016: Neuroscience Bulletin
Aparna Sinha, Lakshmi Jayaraman, Dinesh Punhani, Pradeep Chowbey
BACKGROUND: We discuss the anesthetic outcome in morbidly obese patients under the enhanced recovery after surgery (ERAS) protocol. Our evidence-based clinical pathways focused on prehabilitation and included interventions like aggressive preoperative optimization of medical comorbidities, familiarizing with perioperative protocols, thromboprophylaxis, opioid free multimodal analgesia, and early ambulation. METHODS: We did a retrospective analysis of prospectively collected data of 823 patients who underwent laparoscopic bariatric surgery...
September 6, 2016: Obesity Surgery
Launette Marie Rieb, Wendy V Norman, Ruth Elwood Martin, Jonathan Berkowitz, Evan Wood, Ryan McNeil, M-J Milloy
Withdrawal pain can be a barrier to opioid cessation. Yet, little is known about old injury site pain in this context. We conducted an exploratory mixed-methods descriptive case series using a web-based survey and in-person interviews with adults recruited from pain and addiction treatment and research settings. We included individuals who self-reported a past significant injury that was healed and pain-free prior to the initiation of opioids, which then became temporarily painful upon opioid cessation - a phenomenon we have named withdrawal-associated injury site pain (WISP)...
September 1, 2016: Pain
Leonardo Kapural, Cong Yu, Matthew W Doust, Bradford E Gliner, Ricardo Vallejo, B Todd Sitzman, Kasra Amirdelfan, Donna M Morgan, Thomas L Yearwood, Richard Bundschu, Thomas Yang, Ramsin Benyamin, Abram H Burgher
BACKGROUND: Pain relief with spinal cord stimulation (SCS) has focused historically on paresthesias overlapping chronically painful areas. A higher level evidence supports the use of SCS in treating leg pain than supports back pain, as it is difficult to achieve adequate paresthesia coverage, and then pain relief, in the low back region. In comparison, 10-kHz high-frequency (HF10) SCS therapy does not rely on intraoperative paresthesia mapping and remains paresthesia-free during therapy...
September 6, 2016: Neurosurgery
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